1. Joints, Palpations, & ROM
Foot and Ankle
Joints, Palpations, & ROM

2. Bell Ringer What bones make up the foot? What bones make up the ankle?
What bones make up the lower leg?
What is the main ligament on the medial aspect of the ankle?
What is the ligament most commonly sprained on the lateral side?

3. Answers
5 phalynx (great toe, digits 2-5, w/ DP, PP, DP, MP, PP), Metatarsals 1-5, 3 cuneiforms, Cuboid, Navicular, Talus, Calcaneous
Talus, Tibia, Fibula
Tibia, Fibula
Deltoid Ligament
ATFL (Anterior Talofibular Ligament)

4. Joints:
A synovial joint, also known as a diarthrodial , is the most common and most movable type of joint in the body
Other types: Amphiarthrodial, Synarthrodial
Diarthordial joints are divided into two subdivisions. What are they?
Main structural differences between diarthrodial and Synarthrodial/Amphiarhtordial joints are capsules surrounding the articulating surfaces of a synovial joint and the presence of lubricating synovial fluid within those capsules (synovial cavities).

6. Joints Toes and Metatarsals:
Interphalangeal joints: These joints connect the phalanges. They’re synovial joints strengthened by collateral and plantar ligaments, and they let you flex and extend your toes.
Metatarsophalangeal joints: They allow you to flex and extend your toes, as well as move them apart and closer together.
Intermetatarsal joints
Tarsometatarsal joints
Cuboideonavicular joints

7. joints
Foot:
The following two joints allow you to invert and evert the foot
Subtalar joint: This joint is the posterior joint formed between the talus and the calcaneus. It’s a synovial joint, and it’s stabilized by medial, lateral, and interosseous talocalcaneal ligaments.
Transverse tarsal joint: The transverse tarsal joint is actually a combination of the following two joints:
Talocalcaneonavicular joint
Calcaneocuboid

8. Subtalar Joint

9. Transverse Tarsal Joint

10. Joints
Ankle:
The ankle joint is a hinge joint, so you can plantarflex and dorsiflex
The ankle joint is comprised of:
distal ends of the tibia and fibula
talus

11. ROM Toes Ankle Flexion/extension Abduction/Adduction
Dorsiflexion/plantarflexion
Inversion/eversion
Circumduction

12. Toe ROM

13. Ankle ROM

14. Palpations - Ankle

15. Palpate to feel: palpations Tenderness Inflammation Crepitus Deformity
“Palpate with a purpose”
Palpate to feel:
Tenderness
Inflammation
Crepitus
Deformity

16. What to palpate – Bony Landmarks
From distal to proximal:
Distal, Middle, Proximal Phalangeals
Heads of the Metatarsals
Metatarsals
Navicular Tuberosity
Styloid process of fifth metatarsal
Sinus Tarsi - soft tissue depression just anterior to the lateral malleolus.
Medial and Lateral Malleoli
Head of the Talus
Calcaneous

17. What to Palpate – Muscles and Tendons
Gastrocnemius
Soleus
Achilles Tendon
Tibialis Anterior
Extensor Digitorum Longus Extensor Hallicus Longus
Flexor Digitorum Longus
Peroneus Longus
Peroneus Brevis

18. Some Palpations require ROM
Head of Talus - felt just behind the navicular, by everting & inverting the midfoot.
Sustentaculum Tali - one fingerbreadth below medial malleolus. (serves as an attachment for the spring ligament & supports the talus); can be painful when palpated

19. Palpations - Foot

20. In class… Pair off and palpate the foot and ankle
Identify bones, muscles, and ligaments
Begin to work on foot diagram
Must draw
Tibia
Fibula
All 26 bones of the foot
Must be proportional in size
Color bones by category
Sketch in muscles and ligament
Skeleton will be cut out and assembled; must be able to move

21. What you need to know for the exam
Where to Palpate specific bones/ligaments
ALL ROM

22. Homework
Color pages 4 and 5 in the packet